Understanding Adolescent Expressions of Sadness: A Qualitative Exploration.

PURPOSE: Primary care providers are positioned to identify adolescents at risk for depression and prevent major depressive disorder. To identify subthreshold depression, we examined the language adolescents use to describe their symptoms. METHODS: Adolescents ages 13-18 with elevated levels on the Center for Epidemiologic Studies Depression (CES-D) scale and/or a history of depression who were part of a large randomized clinical trial to prevent depressive disorder were included. We used content analysis to analyze transcripts of semi-structured interviews. RESULTS: Saturation was reached at 37 interviews. Adolescents self-identified as African American (N = 15), Hispanic (N = 10), and White (N = 21). Three domains were revealed; external sources of stress, adolescent expressions of sadness, and seeking help and care. Within these domains, 12 distinct themes emerged contextualizing these domains. No variations in the expression of the themes identified for subthreshold depression were found between the three ethno-cultural groups. IMPLICATIONS FOR PRACTICE: Our study identifies, in adolescents' own words, how adolescents with subthreshold depression express feelings and cope with symptoms, and may guide primary care providers to recognize subthreshold depression early. These findings are a step toward filling the gap in the empirical literature needed to improve identification of adolescents at risk for depression in nonspecialist settings.

Long-term telemental health prevention interventions for youth: A rapid review.

INTRODUCTION: This rapid review identifies and summarizes the effectiveness of preventative telemental health interventions. It investigates studies conducted between 2010 and 2016 that improve mood and anxiety with long-term follow-up. METHODS: A literature search of three major databases was performed by four reviewers. After citation tracing, 3604 studies were discovered, and twenty of these met the inclusion criteria. Data from the papers were abstracted, assessed for quality, and effect sizes were calculated. RESULTS: Salient information was discussed using the Behavioural Vaccine Model of mental illness prevention. This included key concepts such as efficacy, duration of benefits, sociocultural relevance, professional guidance, peer-to-peer support, adherence, delivery and safety. CONCLUSION: This review suggests there are clear prolonged benefits to using technology in youth mental illness prevention. Although this is a rapidly growing area of investigation in countries around the globe, there is still a dearth of research with long-term follow-up. Future studies should aim to boost engagement by increasing motivational guidance in order to recruit at-risk youth of all demographics into these promising intervention programs.

A Resident Initiative Improves Hepatitis C Screening Rates in Primary Care Clinics.

BACKGROUND: Electronic reminders for clinical patient counseling have proven to be an effective response to national recommendations to increase risk factor and birth cohort hepatitis C virus (HCV) screening. It is not known whether a resident-led educational intervention alone could increase screening rates where support for electronic intervention may be limited. OBJECTIVE: We determined whether a resident-designed and resident-implemented educational intervention would significantly improve HCV screening rates in primary care clinics. METHODS: The baseline HCV screening rate was determined retrospectively in our resident community-based primary care clinics. We then implemented an educational intervention that included presenting during resident conference, posting signs in resident work areas, and providing educational pamphlets to patients. We collected screening rate data at 3 and 6 months postintervention. The screening rate was defined as patients screened in clinic divided by the number of patients eligible for screening. RESULTS: The screening rate increased significantly from preintervention (6%, 64 of 1023) to 3 months (35%, 363 of 1026) and 6 months (41%, 443 of 1070) and between 3 and 6 months (P < .001). The percentage of screened patients who pursued testing increased significantly between preintervention (62%, 16 of 26) and 6 months (81%, 105 of 130), and between 3 months (67%, 95 of 141) and 6 months (P = .019). CONCLUSIONS: An educational intervention designed and implemented by residents significantly increased the screening and testing rates for HCV in community-based resident clinics.

Proposed model for the cultural adaptation of an Internet-based depression prevention intervention (CATCH-IT) for Arab adolescents.

Background Evidence-based Internet depression prevention intervention programs are not readily available for Arab youth, but may be effective in this group. Cultural adaptation of evidence-based Western psychotherapy is an important step toward better prevention and treatment of depressive illness in the Arab community. Project CATCH-IT is an Internet-based depression prevention intervention tool that is tailored for adolescents and young adults. Methods The PEN-3 theoretical framework was used for the cultural adaptation of Project CATCH-IT for Arab adolescents. First, a narrative review of existing research about depression in Arab nations was performed. Next, expert opinions about applicability and societal values were obtained. This model was then used to suggest relevant changes to the CATCH-IT modules. These modifications were applied to create sample webpages from the culturally adapted version of CATCH-IT for Arab youth. Results The narrative review, expert opinions and resultant PEN-3 analysis suggest that Internet-based depression interventions are effective, private and confidential. To be most effective, religious leaders and fathers should be the stakeholders approached for dissemination and adequate usage of the service. Arab themes, quotes, language and relevant stories must be incorporated. Conclusion This study sets the background for future studies and research for implementation of the Arabic version of CATCH-IT for the prevention of depression. Using the contextual information provided in this paper to make the necessary changes, huge strides can be made in providing cost-effective and accessible Internet-based interventions to Arab youth.